Common Questions

How long should my baby breastfeed at each feed time?

Breastfeeding is baby-led. There is no set number of times a baby should breastfeed in a day - nor for how long the breastfeed should take. Allow the baby free access to your breasts and as long as he, or she, is feeding effectively and the output (nappies) is appropriate for the baby's age, then frequency and timing of feeds is not necessary.

Initially, before your milk 'comes-in', your baby will feed very frequently - this is natural and encourages a good milk production. Once your milk supply has established your baby may only want to feed on one breast at a feed for a while. However overtime your baby will possibly settle after completing a good feed on one breast, stir on disturbing and not settle. Baby should then be offered the other breast to complete the feed.

All babies and all breasts are different so do not compare your baby's feeding pattern with another. If you have any concerns about your breastfeeding progress contact your Lead Maternity Carer (LMC). If your LMC is unavailable, you can contact one of the following organisations:

Always advise your General Practitioner (GP) and pharmacist that you are breastfeeding. If it is recommended that you stop breastfeeding, because a prescription drug may be incompatible with breastfeeding, we recommend that you request an alternative drug for your required treatment.

If an alternative prescription is not possible, and before discontinuing breastfeeding, check the drug details with a breastfeeding advocate, as sometimes the information contained within the packet is outdated and new research allows breastfeeding to continue.

One bottle of formula isn't going to hurt is it?

Exclusive breastfeeding means that the baby has never, to the mother’s knowledge, had any water, liquid or solid food – only breastmilk, from the breast or expressed and prescribed medicines have been given from birth.

The New Zealand Ministry of Health and World Health Organisation (WHO) recommend that babies are exclusively breastfed until six months of age.

There is substantial international research acknowledges breastfeeding important for optimal health and nutrition – not just while the baby is breastfeeding, but in supporting a lifetime of good health. Breastfeeding also provides positive health and psychological benefits for the mother.

Giving a baby anything orally, other than breastmilk and prescribed medicines, increases the risk of many illnesses including infections and allergies as it exposes the baby to a foreign protein and alters the gut flora at a time when the gut and immune systems are still maturing.

 

While water, if given to a baby less than six months of age, does not expose the baby to a foreign protein it can still impact on the breastfeeding outcome by lessening the time at the breast, and increase the risk of infection.

What are the unique features of the Baby Friendly Initiative (BFI) in NZ?

  • Maternity care is provided by Lead Maternity Carers (LMCs). Women can choose a midwife, obstetrician or general practitioner. LMCs may be employed by a maternity facility or work independently.
  • The Treaty of Waitangi principles of partnership, participation and protection are an integral part of Baby Friendly Initiatives (BFI). The intent is to encourage consistent, evidence-based, culturally appropriate practice at all health and maternity facilities, and community-based services.
  • There has been consumer participation at all levels in the development and review of Baby Friendly Hospital Initiative (BFHI) and Baby Friendly Community Initiative (BFCI) documents. This has been completed by the New Zealand Breastfeeding Alliance (NZBA) Board and BFI Assessors.
  • Informed consent must be given by all women prior to being interviewed and during a BFHI assessment.

Who can I contact to get help with sore nipples resulting from breastfeeding?

The New Zealand Breastfeeding Alliance recommends you contact your Lead Maternity Carer (LMC) if your nipples are causing you concern and breastfeeding is uncomfortable for you. If your LMC is unavailable, you can contact one of the following organisations:

New Zealand Lactation Consultants Association (NZLCA) on 0800 452 282 

La Leche League New Zealand

Who can I contact to find out more about mastitis?

The New Zealand Breastfeeding Alliance recommends you contact your Lead Maternity Carer (LMC), as soon as possible if your breast(s) are painful or uncomfortable. If your LMC is unavailable, you can contact one of the following organisations:

New Zealand Lactation Consultants Association (NZLCA) on 0800 452 282 

La Leche League New Zealand

If you are feeling unwell and have an elevated temperature contact your General Practitioner (GP).

We recommend that you continue to breastfeed your baby whenever possible - or express your breastmilk frequently while you seek help.

Who can I contact if I’m suffering from engorgement?

The New Zealand Breastfeeding Alliance recommends you contact your Lead Maternity Carer (LMC), as soon as possible if your breast(s) are painful or uncomfortable. If your LMC is unavailable, you can contact one of the following organisations:

If you are feeling unwell and have an elevated temperature contact your General Practitioner (GP).

We recommend that you continue to breastfeed your baby whenever possible - or express your breastmilk frequently while you seek help.

What can I do to promote breastfeeding in my community?

  • Check to see if the places you regularly attend are supportive of women who breastfeed. Find out if a place is provided for mothers to comfortably breastfeed their babies. If improvements are needed, help them to understand how breastfeeding is important for the whole community.
  • Thank the management of eating establishments, stores, and public facilities that treat breastfeeding mothers and babies with respect.
  • Donate a book or video on breastfeeding to your local public library. Suggest other materials on breastfeeding for the library to purchase.
  • Ask if local programmes for pregnant teens offer information on breastfeeding. If not, suggest the organisation contact a local La Leche League Leader, an International Board Certified Lactation Consultant or other breastfeeding specialists for help in setting up a breastfeeding support program.
  • Look at the materials offered by your preschool/school to see if breastfeeding is included. If not, suggest to the school board, principal, or teachers of relevant classes that accurate information about breastfeeding is important to future parents.
  • Look around health services waiting rooms to see if there are any materials produced by infant formula manufacturers. When the health care provider recommends breastfeeding, the presence of these materials sends a mixed message to new parents.
  • Ask any group of which you are a member to schedule a presentation on "the importance of breastfeeding to the community" as a topic of discussion or speech. Local lactation consultants, Plunket and La Leche League leaders can help you locate an appropriate speaker.

If I elect to bottle-feed my baby, what should I expect from my maternity service or health professional?

The following guidelines are part of the World Health Organisation (WHO) and United Nations Children's Fund (UNICEF) standards for the Baby Friendly Initiative (BFI).

The Baby Friendly Initiative has standards of care for ALL mothers. To be accredited as "Baby Friendly" the service must meet standards for care for breastfeeding as well as non-breastfeeding mothers.

For mothers who are formula feeding the service is required to provide support ensuring that mothers receive counselling on infant feeding and guidance on selecting options likely to be suitable to their situation.

The BFI assessment includes specific questions targeting the training facility staff about providing support to "non-breastfeeding mothers" and what support these mothers have received. The inclusion of these questions does NOT mean that the BFI is promoting formula feeding, rather, that the BFI wants to ensure ALL mothers, regardless of feeding method, get the feeding support they need.

Health workers have a responsibility to ensure mothers are given information on the importance of breastfeeding so they can make an informed choice. Staff need to support, protect and promote breastfeeding.

Why is this important?

There is significant evidence internationally that breastfeeding contributes positively to infant and maternal health. This evidence confirms that breastfeeding will contribute positively to achieving population health objectives set by the New Zealand Ministry of Health, including:

  • Improving nutrition
  • Reducing obesity
  • Reducing the incidence and impact of cancer
  • Reducing the incidence and impact of cardiovascular disease
  • Reducing the incidence and impact of diabetes

The BFI requires that staff receive education on formula feeding as well the standards of care for the non-breastfeeding mother. Specialist maternity staff (e.g. midwives and lactation consultants), must ensure their knowledge about artificial feeding is current. All mothers should be provided with clear, accurate and unbiased information so that they can make an informed decision on how to feed their babies.

A breastfeeding education programme needs to include information on:

  • the risks of formula feeding
  • how to provide support for non-breastfeeding mothers
  • the safe preparation, handling and feeding of formula
  • the care of formula feeding equipment
  • the importance of skin-to-skin contact and rooming-in 24 hours a day, irrespective of method of feeding
  • what parenting and well child services are available following discharge

Why do we need to talk about the risks of formula feeding?

The World Health Assembly (WHA) Resolution 58.32 urges:

"Member States to ensure that clinicians and other healthcare personnel, community health workers and families, parents and other caregivers, particularly of infants at high risk, are provided with enough information and education by healthcare providers, in a timely manner on the preparation, use and handling of powdered infant formula in order to minimise health hazards; are informed that powdered infant formula may contain pathogenic micro-organisms and must be prepared and used appropriately; and, where applicable, that this information is conveyed through explicit warnings on packaging.' (World Health Assembly, 2005, Resolution 58.32 Geneva: World Health Assembly).

One or more designated staff member(s) may be assigned to the role of educating the non-breastfeeding mother with the practical aspects of artificial feeding, if required. This is the role of the Lead Maternity Carer (LMC), however the staff must ensure mothers have had this information prior to discharge.

The facility must ensure that at least one staff member is available to educate the non-breastfeeding mother on the safe preparation and feeding of infant formula and that this education is provided in private, on a one-to-one basis. If a woman makes an informed decision to artificially feed her baby this decision is to be documented in her clinical notes and thereafter is well supported to do so.

Studies have found that many mothers prepare artificial baby milk incorrectly. It is important that the facility staff provide safe, accurate, and appropriate information. The LMC also has a responsibility to ensure that the mother has understood the instructions so that her baby will not be put at risk from improperly prepared or handled artificial baby milk.

Good counselling and support skills are needed to provide unbiased information to mothers. As part of a baby friendly assessment, BFI Assessors interview non-breastfeeding mothers to ensure they have received the following information:

  • the importance of skin-to-skin contact
  • practical information in safely preparing and giving their babies feeds on an individual basis
  • care for their breasts if they become full and uncomfortable
  • the importance of rooming-in 24 hours a day, safe and unsafe sleep practices
  • how to recognise when their babies are ready to feed
  • cue-based feeding with guidelines for appropriate intake
  • written information on how to get help from the facility and/or how to contact well child providers and parenting support groups
  • all teaching of the preparation and feeding of artificial baby milk has been provided on an individual basis only for those mothers who need it or wish it

It is our goal that all mothers receive support to be able to feed their infants and that they are supported in their decision.